Billing and Coding Quiz
(Updated for 2026) Exam Prep Pack | A+ Questions
50+
& Verified Answers
VERIFIED ANSWERS
Question 1
the higher the E&M codes, _______________________________
Correct Answer
the more complex the visit
Rationale:
In the context of Evaluation and Management (E&M) coding, complexity is a key factor in determining the level of service, as more complex
visits require more time, effort, and decision-making from the healthcare provider, leading to higher reimbursement. The E&M coding system
takes into account factors such as patient history, physical examination, medical decision-making, and counseling to determine the level of
service, with more complex visits typically involving more of these elements.
Question 2
new patient codes are (5)
Correct Answer
99201,99202,99203,99204,9905
Rationale:
The correct codes are based on the CPT (Current Procedural Terminology) coding system, which is used to report medical procedures and
services. In this context, the numbers 99201 through 99204 represent the codes for new patient office or other outpatient visits, which
matches the given statement that new patient codes are (5), implying a total of 5 codes that correspond to different levels of visit complexity.
Question 3
a new patient is defined as:
Correct Answer
a new patient has not been seen in your clinic by a billing member in the last three years
Rationale:
This answer is correct because it highlights a critical aspect of a new patient definition in the medical billing context: time frames and patient
status, specifically focusing on when a patient's status changes from "established" to "new." By not having been seen by a billing member in
the last three years, the patient's status is no longer considered established, and they are therefore considered a new patient.
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, Question 4
an established or follow up patient is:
Correct Answer
someone you or a partner has seen within the last three years
Rationale:
This answer is correct because it highlights the distinction between initial patients and established or follow-up patients, who have a prior
medical relationship and have been seen within a recent timeframe. By specifying the timeframe of "within the last three years", it emphasizes
the continuity of care and establishes the patient's status as an established or follow-up patient.
Question 5
three key components of the document critical to coding
Correct Answer
chief complaint
1-History (HPI, ROS, PMH/PFH,SH)
2-Physical exam
3-Medical decision making (problems,data,risk)
Rationale:
This sequence represents the standard structure of a medical note, allowing coders to accurately identify key information such as the patient's
primary issue, relevant medical history, and physical examination findings, which are essential for assigning the correct ICD-10 code. By
following this structure, coders can extract the necessary data to support coding decisions, ensuring accurate and compliant coding practices.
Question 6
The history includes three major components
Correct Answer
HPI
ROS
PMH/FH/SH
Rationale:
In a medical assessment, the three major components of the history are systematically evaluated to provide a comprehensive understanding of
a patient's condition. HPI (History of Present Illness) examines the patient's current symptoms, ROS (Review of Systems) assesses the entire
body for potential issues, and PMH/FH/SH (Past Medical History/Family History/Social History) reviews the patient's medical and social
background to identify relevant factors.
Question 7
qualifiers specifically relate to the :
Correct Answer
chief complaint
Rationale:
Qualifiers specifically relate to the "chief complaint" because it is the initial statement made by the patient that describes the reason for their
visit, often containing subjective qualifiers like intensity, location, and duration of symptoms. This chief complaint is the foundation for further
questioning and evaluation, and the qualifiers help to refine and clarify the patient's description.
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(Updated for 2026) Exam Prep Pack | A+ Questions
50+
& Verified Answers
VERIFIED ANSWERS
Question 1
the higher the E&M codes, _______________________________
Correct Answer
the more complex the visit
Rationale:
In the context of Evaluation and Management (E&M) coding, complexity is a key factor in determining the level of service, as more complex
visits require more time, effort, and decision-making from the healthcare provider, leading to higher reimbursement. The E&M coding system
takes into account factors such as patient history, physical examination, medical decision-making, and counseling to determine the level of
service, with more complex visits typically involving more of these elements.
Question 2
new patient codes are (5)
Correct Answer
99201,99202,99203,99204,9905
Rationale:
The correct codes are based on the CPT (Current Procedural Terminology) coding system, which is used to report medical procedures and
services. In this context, the numbers 99201 through 99204 represent the codes for new patient office or other outpatient visits, which
matches the given statement that new patient codes are (5), implying a total of 5 codes that correspond to different levels of visit complexity.
Question 3
a new patient is defined as:
Correct Answer
a new patient has not been seen in your clinic by a billing member in the last three years
Rationale:
This answer is correct because it highlights a critical aspect of a new patient definition in the medical billing context: time frames and patient
status, specifically focusing on when a patient's status changes from "established" to "new." By not having been seen by a billing member in
the last three years, the patient's status is no longer considered established, and they are therefore considered a new patient.
Trusted by thousands of students and professionals worldwide Page 1 of 15
, Question 4
an established or follow up patient is:
Correct Answer
someone you or a partner has seen within the last three years
Rationale:
This answer is correct because it highlights the distinction between initial patients and established or follow-up patients, who have a prior
medical relationship and have been seen within a recent timeframe. By specifying the timeframe of "within the last three years", it emphasizes
the continuity of care and establishes the patient's status as an established or follow-up patient.
Question 5
three key components of the document critical to coding
Correct Answer
chief complaint
1-History (HPI, ROS, PMH/PFH,SH)
2-Physical exam
3-Medical decision making (problems,data,risk)
Rationale:
This sequence represents the standard structure of a medical note, allowing coders to accurately identify key information such as the patient's
primary issue, relevant medical history, and physical examination findings, which are essential for assigning the correct ICD-10 code. By
following this structure, coders can extract the necessary data to support coding decisions, ensuring accurate and compliant coding practices.
Question 6
The history includes three major components
Correct Answer
HPI
ROS
PMH/FH/SH
Rationale:
In a medical assessment, the three major components of the history are systematically evaluated to provide a comprehensive understanding of
a patient's condition. HPI (History of Present Illness) examines the patient's current symptoms, ROS (Review of Systems) assesses the entire
body for potential issues, and PMH/FH/SH (Past Medical History/Family History/Social History) reviews the patient's medical and social
background to identify relevant factors.
Question 7
qualifiers specifically relate to the :
Correct Answer
chief complaint
Rationale:
Qualifiers specifically relate to the "chief complaint" because it is the initial statement made by the patient that describes the reason for their
visit, often containing subjective qualifiers like intensity, location, and duration of symptoms. This chief complaint is the foundation for further
questioning and evaluation, and the qualifiers help to refine and clarify the patient's description.
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